NPIMap

Organization Active NPI

Filling Memorial Home Cardinal

  • Intellectual Disabilities Intermediate Care Facility
  • Bryan, OH
National Provider Identifier
1215086640
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
24806 Issued in OH
Legal business name
FILLING MEMORIAL HOME CARDINAL
Practice address
1211 Cardinal Drive
Bryan, OH 43506
Phone
(419) 636-2369
Fax
(419) 636-2869
NPI assigned
Jan 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Carol Cecilia Schroeder, MBOL
Title
Chief Financial Officer
Phone
(419) 592-6451

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 24806 OH Primary

Addresses

Primary practice location

1211 Cardinal Drive
Bryan, OH 43506

Mailing address

N 160 Sr 108
Napoleon, OH 43545-9362
Phone (419) 592-6451

Other identifiers 2

IdentifierTypeStateIssuer
2361457MedicaidOH
9144OtherOHODH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 36G190

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
CARDINAL DRIVE HOME
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Jan 9, 1985
Last certification
Jun 26, 2025
Beds
6
Ownership / control type
Private (non-profit)
Most recent change of ownership
Jan 1, 2003
Facility address
1211 Cardinal Drive
Bryan, OH 43506

National Provider Directory

National Provider Directory
Tax ID family
Filling Memorial Home of Mercy5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215086640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N 160 SR 108",
            "city": "NAPOLEON",
            "state": "OH",
            "postal_code": "435459362",
            "telephone_number": "419-592-6451",
            "fax_number": "419-599-5178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 CARDINAL DRIVE",
            "city": "BRYAN",
            "state": "OH",
            "postal_code": "43506",
            "telephone_number": "419-636-2369",
            "fax_number": "419-636-2869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FILLING MEMORIAL HOME CARDINAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCHROEDER",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "CECILIA",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "419-592-6451",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MBOL"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "OH",
            "license": "24806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2361457",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ODH",
            "identifier": "9144",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, OH

Sources for this page

Verify at the official NPI Registry.